Prognostic Significance of the Highest Mediastinal Lymph Node Involvement in Patients with Stage III-N2 Non-small Cell Lung Cancer.

BACKGROUND: Highest mediastinal lymph node (HMLN) involvement is a category of uncertain resection, yet the prognostic significance of HMLN involvement remains controversial. METHODS: A total of 486 patients with pathological stage III-N2 disease who underwent radical resection were enrolled from January 2015 to December 2018. Patients were allocated into two groups-HMLN involvement (219 cases) and HMLN-negative (249 cases) groups. Kaplan-Meier analysis and Cox proportional hazard regression models were used to evaluate the impact of HMLN involvement on 5-year recurrence-free survival (RFS) and overall survival (OS). RESULTS: The proportion of patients with multiple N2 diseases (72.1% vs. 23.7%; p < 0.001) and stage IIIA (87.2% vs. 77.5%; p < 0.009) were greater in the HMLN-involvement group than in the HMLN-negative group, and the survival rates of the HMLN-involvement group were significantly lower than those of the HMLN-negative group (RFS: 27.2% vs. 49.8%, p < 0.001; OS: 42.1% vs. 59.2%, p = 0.001). HMLN status was an independent factor for OS only (RFS: adjusted hazard ratio [aHR] 1.26, 95% confidence interval CI 0.94-1.68; OS: aHR 1.45, 95% CI 1.07-1.99) in the entire stage III cohort. After stratification of patients according to stage, the involvement of HMLN decreased both RFS and OS in the stage IIIA group (RFS: aHR 1.46, 95% CI 1.06-2.02; OS: aHR 1.70, 95% CI 1.19-2.42); however, no such difference was observed within the stage IIIB group. CONCLUSIONS: HMLN involvement is a prognostic factor of deteriorating survival in highly advanced N2 disease only in patients with stage IIIA.

Clinical and Genomic Analysis of Patients with Short Survival after Surgery for Esophageal Squamous Cell Carcinoma.

BACKGROUND: This study aimed to investigate the prognosis of Chinese patients with esophageal squamous cell carcinoma (ESCC) after surgery and its correlation with genomic alterations (GAs) to identify potential prognostic markers. METHODS: The clinical information, pathological specimens, and follow-up information of 50 patients with stage II and III primary ESCC who were surgically resected in the Fourth Hospital of Hebei Medical University from January 2011 to December 2015 were collected in the present study. Based on overall survival (OS), these patients were divided into the short OS group (<3 years) and the long OS group (>4 years). GA detection was performed in patients with ESCC using next-generation sequencing. All categories of GAs were evaluated; the landscape of GAs in patients with ESCC was mapped; and the correlations between clinical characteristics, prognosis, and GAs were analyzed. RESULTS: There was no skew in the distribution of gender, smoking, and adjuvant therapy between the long OS group and the short OS group. A total of 372 GAs were detected in the 50 patients with ESCC, with 7 types of GAs, including insertions, deletions, and copy number variations, and missense mutations occurred most frequently, with a frequency of >50.0%. Tumor protein 53 (TP53; 50/50, 100%) was the most commonly mutated gene in the entire cohort followed by cyclin D1, cyclin-dependent kinase inhibitor 2A (CDKN2A), and fibroblast growth factor 19. More CDKN2A loss (p = 0.098) was detected in the short OS group than in the long OS group. The results of the multivariate analysis after adjustment for clinical factors showed a statistically significant difference in the CDKN2A loss between the two groups. Data obtained from The Cancer Genome Atlas for surgical ESCC revealed that the CDKN2A loss may be responsible for the poorer prognosis in postoperative patients with ESCC. CONCLUSION: In patients with progressive primary ESCC, the poor postoperative prognosis may be epiphenomenally associated with the CDKN2A loss.

CAF-derived exosomes deliver LINC01410 to promote epithelial-mesenchymal transition of esophageal squamous cell carcinoma.

Exosomes mediate cellular communications in cancer by transmitting active molecules. However, the CAFs-derived molecular determinants that regulate esophageal squamous cell carcinoma (ESCC) metastasis have not been fully characterized. The purpose of this study was to investigate the potential roles of exosomal LINC01410 of ESCC cells. The characteristics of exosomes were identified using transmission electron microscope (TEM), Nanoparticle Tracking Analysis (NTA). The expression of LINC01410 and miR-122-5p was analyzed by quantitative real-time polymerase chain reaction (qRT-PCR) assay. The biological roles of LINC01410 in ESCC cells were investigated using transwell assay. Western blot assay was employed to detect protein levels. The potential downstream molecular mechanism of LINC01410 was demonstrated with dual-luciferase reporter assay, RNA immunoprecipitation (RIP) assay and RNA pull down. CAFs promote the metastasis and epithelial-mesenchymal transition (EMT) of ESCC cells. CAFs exert their roles by transferring exosomes to ESCC cells, leading to a significant increase of LINC01410 level in ESCC cells. Mechanically, LINC01410 secreted by CAFs-Exo could contribute to metastasis and EMT by sponging miR-122-5p and increasing PKM2 level in TE-1 and Eca-109 cells. Additionally, LINC01410/miR-122-5p/PKM2 axis affecting ESCC metastasis and EMT in vitro and in vivo.

Association between number of dissected lymph nodes and survival in patients undergoing resection for clinical stage IA pure solid lung adenocarcinoma: a retrospective analysis.

BACKGROUND: Lymph node dissection is essential for staging of pure solid lung adenocarcinoma and selection of treatment after surgical resection, particularly for stage I disease since the rate of lymph node metastasis can vary from 0 to 23.7%. METHODS: We retrospectively screened all adult patients (18 years of age or older) who underwent lobectomy for pure solid cT1N0M0 lung adenocarcinoma between January 2015 and December 2017 at our center. Cox proportional hazard regression was used to assess the association between the number of dissected lymph nodes and recurrence-free survival (RFS) and to determine the optimal number of dissected lymph nodes. RESULTS: The final analysis included 458 patients (age: 60.26 ± 8.07 years; 241 women). RFS increased linearly with an increasing number of dissected lymph nodes at a range between 0 and 9. Kaplan-Meier analysis revealed significantly longer RFS in patients with ≥ 9 vs. <9 dissected lymph nodes. In subgroup analysis, ≥ 9 dissected lymph nodes was not only associated with longer RFS in patients without lymph node metastasis (n = 332) but also in patients with metastasis (n = 126). In multivariate Cox proportional hazard regression, ≥ 9 dissected lymph nodes was independently associated with longer RFS (hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.26 to 0.73; P = 0.002). CONCLUSIONS: ≥9 Dissected lymph nodes was associated with longer RFS; accordingly, we recommend dissecting 9 lymph nodes in patients undergoing lobectomy for stage IA pure solid lung adenocarcinoma.

Improved LC-MS/MS method for the simultaneous quantification of tacrolimus and cyclosporine A in human blood and application to therapeutic drug monitoring.

In order to facilitate therapeutic drug monitoring of tacrolimus and cyclosporine A in clinical practice, a simple, rapid, robust, sensitive and specific LC-MS/MS assay was developed and validated for the simultaneous determination of tacrolimus and cyclosporine A in human whole blood. Erythrocytes were destroyed using internal standard solution with 10% (w/v) zinc sulfate in water. The analytes were extracted from 100 µl of whole blood by protein precipitation with acetonitrile. Chromatographic separation was conducted on a Kinetex PFP column (60°C) by a gradient elution with a flow rate of 0.450 ml/min in 2.5 min. Quantitative analysis was performed using electrospray ionization and multiple reaction monitoring in positive ionization mode. The method was fully validated as per current guidelines on bioanalytical methodologies of the US Food and Drug Administration and European Medicines Agency. The method developed was applied successfully in analyzing clinical samples from patients administered tacrolimus or cyclosporine A. The sample treatment procedure was rationalized and improved to fulfill the complete target extraction. The chromatography conditions were optimized to achieve rapid and accurate quantification of both analytes. This method may be beneficial as a constructive input for the therapeutic drug monitoring of tacrolimus and cyclosporine A in obtaining individualized therapy.

Elevated circulating PCSK9 level is associated with 28-day mortality in patients with sepsis: a prospective cohort study.

OBJECTIVES: Pro-protein convertase subtilisin/kexin 9 (PCSK9) decreases the clearance of the pathogenic lipids, supporting the potential role of PCSK9 in the prognosis of sepsis. METHODS: In this prospective cohort study, patients with sepsis were consecutively recruited from 1 to 2020 to 30 September 2021 at the First People's Hospital of Huaihua, China. All the eligible patients were categorized into low-PCSK9 and high-PCSK9 groups, based on their PCSK9 levels at admission. Time-dependent receiver operating characteristic curves and Cox proportional hazards regression were used to evaluate the association between PCSK9 level and 28-day mortality of sepsis. RESULTS: Of the 203 enrolled patients, 56 (27.59%) died during the 28-day follow-up. The PCSK9 level was positively related to the C-reactive protein level. The cut-off point of PCSK9 levels for 28-day mortality risk was 370 ng/ml. Through comparison between high-PCSK9 (> 370 ng/ml) with low-PCSK9 (≤ 370 ng/ml) groups, the adjusted HR for mortality was 2.56 (95% CI: 1.25-5.23, p = 0.01). CONCLUSIONS: The 28-day mortality of sepsis increased significantly as the baseline circulating PCSK9 level exceeded 370 ng/ml, indicating circulating PCSK9 levels may be a potential biomarker to predict the prognosis of sepsis.

Production-Based and Consumption-Based Accounting of Global Cropland Soil Erosion.

The effective control of cropland soil erosion is urgent for all countries because of its threat to global food security. Cropland soil erosion is caused by agricultural production and driven indirectly by consumption. Analyzing the causes and preventive strategies from the consumption side is essential for soil erosion control. However, there is not yet sufficient research or practice. In this study, we estimated global cropland soil erosion with the revised universal soil loss equation, allocated it to specific types of crops, and quantified the cropland soil erosion footprint of the economies with a multiregional input-output analysis model. Our results showed that developed economies, usually importing cropland soil erosion from developing or agriculturally developed economies, are the beneficiaries in the current crop trading system. The European Union is the largest net importer, while Brazil is the largest exporter. The indirect and induced sectors are the main contributors, consuming approximately 70.48% of the total cropland soil erosion. Our results revealed the region- and product-specific contributors that could inform the reduction of global cropland soil erosion for sustainable food production and consumption.

Inland water bodies in China: Features discovered in the long-term satellite data.

Water bodies (WBs), such as lakes, ponds, and impoundments, provide essential ecosystem services for human society, yet their characteristics and changes over large areas remain elusive. Here we used unprecedented data layers derived from all Landsat images available between 1984 and 2015 to understand the overall characteristics and changes of WBs between 2 epochs (i.e., 1984 to 1999 and 2000 to 2015) in China. Results show that the abundance estimate of WBs greater than 1 km2 and the total WB surface area were 0.3 to 1.5 times and 0.2 to 0.5 times more than the previous estimates, respectively. The size-abundance and shoreline-area relationships of WBs in China conformed to the classic power scaling law, in contradiction to most previous studies. WB changes with various occurrence probabilities show widespread coexistence of disappearance of existent and emergence of new WBs across China driven primarily by human activities and climate change. Our results highlight the importance of using appropriate long-term satellite data to reveal the true properties and dynamics of WBs over large areas, which is essential for developing scaling theories and understanding the relative impacts of human activities and climate change on water resources in the world.

Integrase inhibitors versus efavirenz combination antiretroviral therapies for TB/HIV coinfection: a meta-analysis of randomized controlled trials.

BACKGROUND: Integrase inhibitors (INIs)-based antiretroviral therapies (ART) are more recommended than efavirenz (EFV)-based ART for people living with HIV/AIDS (PLWHA). Yet, the advantage of integrase inhibitors in treating TB/HIV coinfection is uncertain. Therefore, the objective of this systematic review is to evaluate the effects and safety of INIs- versus EFV-based ART in TB/HIV coinfection, and demonstrate the feasibility of the regimens. METHODS: Four electronic databases were systematically searched through September 2020. Fixed-effects models were used to calculate pooled effect size for all outcomes. The primary outcomes were virologic suppression and bacteriology suppression for INIs- versus EFV-based ART. Secondary outcomes included CD4+ cell counts change from baseline, adherence and safety. RESULTS: Three trials (including 672 TB/HIV patients) were eligible. ART combining INIs and EFV had similar effects for all outcomes, with none of the point estimates argued against the INIs-based ART on TB/HIV patients. Compared to EFV-based ART as the reference group, the RR was 0.94 (95% CI 0.85 to 1.05) for virologic suppression, 1.00 (95% CI 0.95 to 1.05) for bacteriology suppression, 0.98 (95% CI 0.95 to 1.01) for adherence. The mean difference in CD4+ cell counts increase between the two groups was 14.23 cells/µl (95% CI 0- 6.40 to 34.86). With regard to safety (adverse events, drug-related adverse events, discontinuation for drugs, grade 3-4 adverse events, IRIS (grade 3-4), and death), INIs-based regimen was broadly similar to EFV-based regimens. The analytical results in all sub-analyses of raltegravir- (RAL) and dolutegravir (DTG) -based ART were valid. CONCLUSION: This meta-analysis demonstrates similar efficacy and safety of INIs-based ART compared with EFV-based ART. This finding supports INIs-based ART as a first-line treatment in TB/HIV patients. The conclusions presented here still await further validation owing to insufficient data.

Circular RNA MTO1 intercorrelates with microRNA-630, both associate with Enneking stage and/or pathological fracture as well as prognosis in osteosarcoma patients.

OBJECTIVE: Circular RNA-mitochondrial tRNA translation optimization 1 (circ-MTO1) not only involves in bioprocess of various cancers, but also regulates osteosarcoma progression by regulating microRNA-630 (miR-630). However, the clinical role of circ-MTO1 and miR-630 in osteosarcoma is still obscure. This study aimed to assess the correlation of circ-MTO1 and miR-630 with disease features and prognosis and to explore their association with each other in osteosarcoma patients. METHODS: Forty-four osteosarcoma patients who received neoadjuvant chemotherapy to surgical resection were analyzed in this retrospective study. Then, circ-MTO1 and miR-630 expressions were evaluated in tumor and adjacent non-tumor specimens by reverse transcription quantitative polymerase chain reaction. RESULTS: Circ-MTO1 was lower in tumor than in non-tumor tissues (p<0.001); meanwhile, its elevated tumor expression was correlated with less advanced Enneking stage (p=0.049), good neoadjuvant chemotherapy response (p=0.029), and longer disease-free survival (DFS) (p=0.047). However, no association was found between circ-MTO1 and overall survival (OS) (p=0.122). Additionally, miR-630 in tumor was higher than in non-tumor tissues (p<0.001), while its raised tumor expression was associated with pathological fracture occurrence (p=0.003), advanced Enneking stage (p=0.036), poor neoadjuvant chemotherapy response (p=0.035), and shorter DFS (p=0.011). However, no association was found between miR-630 and OS (p=0.066). In addition, tumor circ-MTO1 was negatively associated with miR-630 (r=-0.323, p=0.032). CONCLUSION: Circ-MTO1 and miR-630 expressions are inter-correlated and dysregulated in osteosarcoma patients. Besides, they associate with Enneking stage and/or pathological fracture, as well as neoadjuvant treatment response and accumulating DFS in these patients.

Using structural equation modelling to identify regional socio-economic driving forces of soil erosion: A case study of Jiangxi Province, southern China.

Socioeconomic factors are key driving forces for the occurrence and development of soil erosion, but their effects are not well understood. To analyse the relationship between the socioeconomic system and soil erosion, a framework was proposed and validated with structural equation modelling. Population pressure, economic development, agricultural inputs and outputs and soil erosion are latent variables of the framework. A case study was conducted in Jiangxi Province. The results showed that economic development was the key controlling factor and that agricultural output was the main promoting factor for soil erosion, with path coefficients of -1.321 and 1.609 in 1995 and -0.624 and 0.453 in 2010, respectively. This implied that the contradiction between socioeconomic development and ecological protection was alleviated during the study period. Agricultural input controlled severe soil erosion (-|0.322) while promoting mild soil erosion (0.095), which indicated that more attention should be paid to the adverse impact of excessive agricultural inputs on soil erosion control. The identification of the socioeconomic driving forces of regional soil erosion could help adjust the development strategy and mitigate the negative effects of economic development on soil erosion control and ecological conservation.

Industrial polycyclic aromatic hydrocarbons (PAHs) emissions embodied in domestic trade in China in 2012.

Atmospheric Polycyclic Aromatic Hydrocarbons (PAHs) emissions cause non-negligible damage to human health and well-being. Effective regional cooperation is urgently required to mitigate PAHs emissions to maintain satisfactory air quality. This study quantified and tracked China's PAHs emissions flows embodied in interprovincial trade. A production-based emissions inventory of 16 U.S. EPA priority PAHs based on commercial energy consumption in China in 2012 was compiled using the emissions factor approach. Then, a multiregional input-output model was constructed to reveal consumption-based emissions and to track the PAHs emissions embodied in the trade of 27 major sectors across 30 regions in China. Key structural paths were also identified using structural path analysis (SPA). In 2012, the total industrial energy-derived PAHs emissions were estimated to be 47.7 tons of BaP-toxic equivalents (8032.7 tons of mass). Shandong, Hebei, and Hubei accounted for more than 24.0% of the production-side PAHs emissions in the whole country. Approximately 30.8% of China's PAHs emissions were embodied in goods consumed outside of the province in which they were produced. PAHs flow tended to start in the western regions and ended in the eastern regions along the coast. The results of the SPA showed that critical paths, such as from the Metallurgy sector to the Construction sector, embodied a large amount of emissions and had the potential to affect the performance of the entire system. By paying attention to the consumption-based accounting as well as the production-based accounting of emissions and by focusing on vital transfer paths, policymakers can devise effective and targeted environmental protection and sustainable development policies in China.

Telecoupling cropland soil erosion with distant drivers within China.

Soil erosion on cropland is a result of the interaction between nature and human activities. The socioeconomic influencing factors of soil erosion have been less studied than the biophysical processes and previous studies have mainly focused on the impacts of local socioeconomic factors on soil erosion in the same region. However, since agricultural activities are densely connected to other socio-economic activities, the need for agricultural products from distant regions could potentially drive local soil erosion accompanying agricultural production. To the best of our knowledge, these telecoupling effects have not been studied. Here, we combined the Revised Universal Soil Loss Equation (RUSLE) and multiregional input-output analysis (MRIO) models to quantify the contribution of China's cross-provincial economic demand to local soil erosion at the provincial, sectoral, and supply chain levels. Our results show that a large amount of soil erosion in the southwest, northeast, and central regions is linked to the economic needs across provinces. Agriculture and food processing are the most important distant driving sectors. The driving effect of household consumption on soil erosion mainly occurs on shorter supply chains, while exports and capital formation drive soil erosion through longer chains. Our results indicate that local soil erosion management must consider the impact of distant agricultural product needs and coordinate food production and supply on a national scale to protect the ecological function of the land.

Efficacy of orchard terrace measures to minimize water erosion caused by extreme rainfall in the hilly region of China: Long-term continuous in situ observations.

Terracing and rainfall characteristics notably influence the water erosion processes. However, an extensive long term in situ quantitative evaluation of the approaches to control the water erosion in different orchard terraces has not yet been performed, especially considering the increasing frequency and severity of extreme rainfall events due to the global climate change. In this study, six types of orchard terraces, including slope land as the control (SLck), level terrace with bare (LTb) and vegetation taluses (LTv), outward (OTv) and inward terrace (ITv) with vegetation taluses and level terrace having front mounds and back ditches with vegetation taluses (MDLTv), were used to analyze the effects of extreme and ordinary rainfall events on the surface runoff and soil erosion. According to the measured data for twelve consecutive years, 356 natural rainfall events were divided into extreme and ordinary rainfall, based on the World Meteorological Organization standard. The results indicated that more severe surface runoff and sediment loss occurred under extreme rainfall: the runoff coefficient and soil loss under extreme rainfall were 2.6 and 11.5 times those under ordinary rainfall, respectively. The sediment yield (contribution rate, 42.9%) exhibited a higher sensitivity to extreme rainfall events compared to that of the surface runoff generation (contribution rate, 16.4%). Moreover, the reduction in the surface runoff and sediment in the extreme rainfall case differed for different orchard terraces. The average surface runoff coefficient and soil loss amount decreased in the following order: SLck>LTb>OTv>LTv>ITv>MDLTv. Nevertheless, the highest and lowest contributions of the extreme rainfall to the sediment yield occurred in the LTb (64.8%) and MDLTv (21.7%) plots, respectively. Therefore, severe talus erosion caused by extreme rainfall should be monitored, and a combination of vegetation taluses and front mounds and back ditches on the platforms is recommended as a sustainable strategy to prevent extreme water erosion when transforming slope land into orchard terraces.

Transmission and clinical characteristics of coronavirus disease 2019 in 104 outside-Wuhan patients, China.

Cases of coronavirus disease 2019 (COVID-19) emigrating from Wuhan escalated the risk of spreading the disease in other cities. This report focused on outside-Wuhan patients to assess the transmission and clinical characteristics of this illness. Contact investigation was conducted on each patient who was admitted to the assigned hospitals in Hunan Province (geographically adjacent to Wuhan) from 22 January to 23 February 2020. Cases were confirmed by the polymerase chain reaction test. Demographic, clinical, and outcomes were collected and analyzed. Of the 104 patients, 48 (46.15%) were cases who immigrated from Wuhan; 93 (89.42%) had a definite contact history with infection. Family clusters were the major body of patients. Transmission along the chain of three "generations" was observed. Five asymptomatic infected cases were found and two of them infected their relatives. Mean age was 43 (range, 8-84) years, and 49 (47.12%) were male. The median incubation period was 6 (range, 1-32) days, which of 8 patients ranged from 18 to 32 days, 96 (92.31%) were discharged, and 1 (0.96%) died. The average hospital stay was 10 (range, 8-14) days. Family but not community transmission became the main body of infections in the two centers, suggesting the timely control measures after the Wuhan shutdown worked well. Asymptomatic transmission demonstrated here warned us that it may lead to the widespread of COVID-19. A 14-day quarantine may need to be prolonged.

Baricitinib induces LDL-C and HDL-C increases in rheumatoid arthritis: a meta-analysis of randomized controlled trials.

BACKGROUND: Baricitinib, an oral-administrated selective inhibitor of the JAK1 and JAK2, is recently approved for rheumatoid arthritis (RA) treatment. With the aim to provide some insights on the clinical safety, the current study mainly focused on the effect of baricitinib on low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels and cardiovascular risk. METHODS: The net change scores [least squares mean (LSM) and mean change] of LDL-C and HDL-C levels from baseline with the comparison of baricitinib versus placebo were pooled, respectively. Risk rations (RR) of major cardiovascular events (MACEs) and differences of cardiovascular risk scores at the end of treatment across groups were compared. RESULTS: Six trials with randomized 3552 patients were finally included in summary analysis. Results showed that baricitinib significantly increased LDL-C levels, the net mean change was 13.15 mg/dl with 95% CI 8.89~17.42 (I2 = 0) and the net LSM was 11.94 mg/dl with 95% CI 7.52~16.37 (I2 = 84%). HDL-C also increased obviously with the net LSM change was 7.19 mg/dl (95% CI, 6.05~8.33, I2 = 47%) and net mean change was 5.40 mg/dl (95% CI, 3.07~7.74, I2 = 10%). Subgroup and meta-regression analysis demonstrated baricitinib induced LDL-C and HDL-C increases in a dose-response manner. However, both the pooled RRs of MACEs and differences of cardiovascular risk scores were not statistically significant across groups. CONCLUSION: This study confirmed that baricitinib induced a stable dose-response increase in LDL-C and HDL-C levels. Since the causality association between altered lipids and cardiovascular risk was not identified yet, this issue cannot be completely dismissed. Future research is needed to fully dissect the implications of these lipid changes.

Effect of Soil Fulvic and Humic Acids on Pb Binding to the Goethite/Solution Interface: Ligand Charge Distribution Modeling and Speciation Distribution of Pb.

The effect of adsorbed soil fulvic (JGFA) and humic acid (JGHA) on Pb binding to goethite was studied with the ligand charge distribution (LCD) model and X-ray absorption fine structure (XAFS) spectroscopy analysis. In the LCD model, the adsorbed small JGFA particles were evenly located in the Stern layer, but the large JGHA particles were distributed over the Stern layer and the diffuse layer, which mainly depended on the JGHA diameter and concentrations. Specific interactions of humic substances (HS) with goethite were modeled by inner-sphere complexes between the -FeOH20.5+ of goethite and the -COO- of HS and by Pb bridges between surface sites and COO- groups of HS. At low Pb levels, nearly 100% of Pb was bound as Pb bridges for both JGFA and JGHA. At high Pb levels and low HS loading, Pb-goethite almost dominated over the entire studied pH range, but at high HS loading, the primary species was goethite-HS-Pb at acidic pH and goethite-Pb at alkaline pH. Compared with JGFA, there was a constant contribution of Pb bridges of about 10% for JGHA. The linear combination fit of EXAFS, using Pb-HS and Pb-goethite as references, indicated that with increased HS loading more Pb was bound to adsorbed HS and less to goethite, which supported the LCD calculations.

Blood concentrations of lead, cadmium, mercury and their association with biomarkers of DNA oxidative damage in preschool children living in an e-waste recycling area.

Reactive oxygen species (ROS)-induced DNA damage occurs in heavy metal exposure, but the simultaneous effect on DNA repair is unknown. We investigated the influence of co-exposure of lead (Pb), cadmium (Cd), and mercury (Hg) on 8-hydroxydeoxyguanosine (8-OHdG) and human repair enzyme 8-oxoguanine DNA glycosylase (hOGG1) mRNA levels in exposed children to evaluate the imbalance of DNA damage and repair. Children within the age range of 3-6 years from a primitive electronic waste (e-waste) recycling town were chosen as participants to represent a heavy metal-exposed population. 8-OHdG in the children's urine was assessed for heavy metal-induced oxidative effects, and the hOGG1 mRNA level in their blood represented the DNA repair ability of the children. Among the children surveyed, 88.14% (104/118) had a blood Pb level >5 µg/dL, 22.03% (26/118) had a blood Cd level >1 µg/dL, and 62.11% (59/95) had a blood Hg level >10 µg/dL. Having an e-waste workshop near the house was a risk factor contributing to high blood Pb (r s  = 0.273, p < 0.01), while Cd and Hg exposure could have come from other contaminant sources. Preschool children of fathers who had a college or university education had significantly lower 8-OHdG levels (median 242.76 ng/g creatinine, range 154.62-407.79 ng/g creatinine) than did children of fathers who had less education (p = 0.035). However, we did not observe a significant difference in the mRNA expression levels of hOGG1 between the different variables. Compared with children having low lead exposure (quartile 1), the children with high Pb exposure (quartiles 2, 3, and 4) had significantly higher 8-OHdG levels (ß Q2 = 0.362, 95% CI 0.111-0.542; ß Q3 = 0.347, 95% CI 0.103-0.531; ß Q4 = 0.314, 95% CI 0.087-0.557). Associations between blood Hg levels and 8-OHdG were less apparent. Compared with low levels of blood Hg (quartile 1), elevated blood Hg levels (quartile 2) were associated with higher 8-OHdG levels (ß Q2 = 0.236, 95% CI 0.039-0.406). Compared with children having low lead exposure (quartile 1), the children with high Pb exposure (quartiles 2, 3, and 4) had significantly higher 8-OHdG levels.